Salvage Radiation Therapy Please complete this survey only if you have had a radical prostatectomy and have had salvage radiation therapy (SRT) after your surgery because your PSA started rising. OK Question Title * 1. Was your PSA undetectable after surgery? Yes No OK Question Title * 2. What was your PSA when you started your salvage radiation therapy? OK Question Title * 3. For your post-surgery pathology, did you have: Yes No Positive surgical margins? Positive surgical margins? Yes Positive surgical margins? No Lymph node involvement? Lymph node involvement? Yes Lymph node involvement? No Seminal vesicle involvement? Seminal vesicle involvement? Yes Seminal vesicle involvement? No Other (please specify) OK Question Title * 4. Did you complete any imaging/scans to determine the location of the cancer prior to starting your salvage radiation therapy? Yes No If yes, please specify what type of imaging/scan: OK Question Title * 5. How many months has it been since you completed your salvage radiation therapy? OK Question Title * 6. How would you describe your quality of life in each of the areas below AFTER surgery but BEFORE salvage radiation therapy: No impact Nuisance impact Moderate impact Substantial impact Complete loss of function N/A Urinary control/incontinence? Urinary control/incontinence? No impact Urinary control/incontinence? Nuisance impact Urinary control/incontinence? Moderate impact Urinary control/incontinence? Substantial impact Urinary control/incontinence? Complete loss of function Urinary control/incontinence? N/A Erectile dysfunction? Erectile dysfunction? No impact Erectile dysfunction? Nuisance impact Erectile dysfunction? Moderate impact Erectile dysfunction? Substantial impact Erectile dysfunction? Complete loss of function Erectile dysfunction? N/A Bowel control? Bowel control? No impact Bowel control? Nuisance impact Bowel control? Moderate impact Bowel control? Substantial impact Bowel control? Complete loss of function Bowel control? N/A OK Question Title * 7. How would you describe your quality of life in each of the areas below AFTER salvage radiation therapy: Improved slightly Remained the same Worsened slightly Worsened substantially Complete loss of function N/A Urinary control/incontinence? Urinary control/incontinence? Improved slightly Urinary control/incontinence? Remained the same Urinary control/incontinence? Worsened slightly Urinary control/incontinence? Worsened substantially Urinary control/incontinence? Complete loss of function Urinary control/incontinence? N/A Erectile dysfunction? Erectile dysfunction? Improved slightly Erectile dysfunction? Remained the same Erectile dysfunction? Worsened slightly Erectile dysfunction? Worsened substantially Erectile dysfunction? Complete loss of function Erectile dysfunction? N/A Bowel control? Bowel control? Improved slightly Bowel control? Remained the same Bowel control? Worsened slightly Bowel control? Worsened substantially Bowel control? Complete loss of function Bowel control? N/A Other (please specify) OK Question Title * 8. Did you receive hormone therapy in conjunction with your salvage radiation therapy? No, I did not receive hormone therapy before or during salvage radiation therapy. Yes, I started hormone therapy before starting salvage radiation therapy. Yes, I started hormone therapy during salvage radiation therapy. Other (please specify) OK Question Title * 9. Please share any other information about your experience that would be useful to someone who would be starting salvage radiation therapy. OK DONE